Diferencia entre revisiones de «Midazolam»

Revisión actual - 21:56 20 mar 2026

See critical care quick reference for drug doses by weight.

General

Type: Benzodiazepines
Dosage Forms: IV
Common Trade Names: Versed

Adult Dosing

Anxiolysis/sedation:
- 1-2mg IV push
- 0.07 to 0.08 mg/kg IM, usual dose 5 mg for 60 kg pt
Seizure:
- 10mg IM/IV
ICU Sedation:
- Load: 10-50mcg/kg IV infusion
- Maintenance: 20-100 mcg/kg/hr infusion
- Use with standardized sedation protocol for titration

Pediatric Dosing

See critical care quick reference for drug doses by weight.

Anxiolysis/sedation:
- 6mo-5yr: 0.05-0.1 mg/kg IV push
- 6-12yr: 0.025-0.05 mg/kg IV push

Intranasal
- Seizure: 0.2 mg/kg IN divided between nostrils
- Procedural sedation: 0.2-0.6 mg/kg IN divided between nostrils
- Anxiolysis: 0.5 mg/kg IN (max dose 10 mg)

Special Populations

Pregnancy Rating: D
- Maternal use shortly before delivery associated with floppy infant syndrome
Lactation: Distributed in breast milk, use with caution
Renal Dosing:
- Adult: Decrease by 50% for severe renal failure
- Pediatric
Hepatic Dosing:
- Adult: Prolonged clearance in cirrhosis
- Pediatric

Contraindications

Allergy to class/drug

Adverse Reactions

Serious

Apnea
Hypopnea
Hypotension
Delirium, when used for prolonged periods in ICU setting

Common

Drowsiness
Nausea/vomiting

Pharmacology

Peak effect:
- IM: Children: 15 to 30 minutes; Adults: 30 to 60 minutes
- IV: 5 to 7 minutes
- Intranasal: 10 minutes
Duration
- IV: Single dose: <2 hours (dose-dependent),up to 6 hours with cirrhosis
- IM: Up to 6 hours; Mean: 2 hours
- Intranasal: Children: 18 to 41 minutes
Half-life: 1.8-6.4 hr
Metabolism: Metabolized in liver by CYP3A4 to active metabolite α₁-hydroxymidazolam
Excretion: Renal
Mechanism of Action: CNS depressant. Acts at GABA receptor to increase frequency of chloride channel opening, causing hyperpolarization and stabilization of neuronal membrane.

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Agitated or combative patient	5 mg IM	Benzodiazepine for agitation	IM	Adult
Excited delirium	5 mg	Benzodiazepine sedation	IM	Adult
Procedural sedation	1-2 mg	Procedural sedation (with fentanyl)	IV	Adult
Rapid sequence intubation	0.2-0.3 mg/kg	Induction	IV	Adult
Status epilepticus (peds)	0.2mg/kg IM/intranasal (max 10mg/dose)	Prehospital first-line for pediatric status epilepticus	IM/IN	Pediatric

References

Micromedex

Authors:

@@ Línea 1: / Línea 1: @@
 ''See [[critical care quick reference]] for drug doses by weight.''
 ==General==
-*Type: [[Benzodiazepines]]
+*Type: [[Is DrugClass::Benzodiazepines]]
-*Dosage Forms:
+*Dosage Forms: IV
-*Common Trade Names:
+*Common Trade Names: [[BrandName::Versed]]
 ==Adult Dosing==
-*2mg IV
+*[[Has Indication::Anxiolysis]]/[[Has Indication::sedation]]:
+**1-2mg IV push
+**0.07 to 0.08 mg/kg IM, usual dose 5 mg for 60 kg pt
+*[[Seizure]]:
+**[[SeizureDose::10mg IM/IV]]
+*ICU Sedation:
+**Load: 10-50mcg/kg IV infusion
+**Maintenance: 20-100 mcg/kg/hr infusion
+**Use with standardized sedation protocol for titration
 ==Pediatric Dosing==
 ''See [[critical care quick reference]] for drug doses by weight.''
+*Anxiolysis/sedation:
+**6mo-5yr: 0.05-0.1 mg/kg IV push
+**6-12yr: 0.025-0.05 mg/kg IV push
+*Intranasal
+**[[Has Indication::Seizure]]: 0.2 mg/kg IN divided between nostrils
+**Procedural sedation: 0.2-0.6 mg/kg IN divided between nostrils
+**Anxiolysis: 0.5 mg/kg IN (max dose 10 mg)
 ==Special Populations==
-*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
+*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D
-*Lactation:
+**Maternal use shortly before delivery associated with floppy infant syndrome
-*Renal Dosing
+*Lactation: Distributed in breast milk, use with caution
-**Adult
+*Renal Dosing:
+**Adult: Decrease by 50% for severe renal failure
 **Pediatric
-*Hepatic Dosing
+*Hepatic Dosing:
-**Adult
+**Adult: Prolonged clearance in cirrhosis
 **Pediatric
@@ Línea 26: / Línea 43: @@
 ==Adverse Reactions==
 ===Serious===
+*Apnea
+*Hypopnea
+*Hypotension
+*[[Delirium]], when used for prolonged periods in ICU setting
 ===Common===
+*Drowsiness
+*[[Nausea/vomiting]]
 ==Pharmacology==
-*Half-life:
+*Peak effect:
-*Metabolism:
+**IM: Children: 15 to 30 minutes; Adults: 30 to 60 minutes
-*Excretion:
+**IV: 5 to 7 minutes
-*Mechanism of Action:
+**Intranasal: 10 minutes
+*Duration
+**IV: Single dose: <2 hours (dose-dependent),up to 6 hours with cirrhosis
+**IM: Up to 6 hours; Mean: 2 hours
+**Intranasal: Children: 18 to 41 minutes
+*Half-life: 1.8-6.4 hr
+*Metabolism: Metabolized in liver by CYP3A4 to active metabolite α<sub>1</sub>-hydroxymidazolam
+*Excretion: Renal
+*Mechanism of Action: CNS depressant. Acts at GABA receptor to increase frequency of chloride channel opening, causing hyperpolarization and stabilization of neuronal membrane.
+==Indications by Condition==
+''The following table is automatically generated from disease/condition pages across WikEM.''
+{{#ask:[[Has DrugName::Midazolam]]
+ |?Has Indication=Indication
+ |?Has Dose=Dose
+ |?Has Context=Context
+ |?Has Route=Route
+ |?Has Population=Population
+ |format=table
+ |headers=plain
+ |mainlabel=-
+ |sort=Has Indication
+ |limit=50
+}}
 ==See Also==
+*[[Intranasal sedation]]
-==Sources==
+==References==
+Micromedex
 <references/>
-[[Category:Drugs]]
+[[Category:Pharmacology]]